Dr. A. Gwardjan

The applicant sought statutory accident benefits following a motor vehicle accident.

The insurer denied benefits, arguing the applicant's injuries fell within the Minor Injury Guideline (MIG).

The Licence Appeal Tribunal found that the applicant demonstrated chronic pain with functional impairment, warranting removal from the MIG.

However, the Tribunal dismissed the claims for a physiotherapy treatment plan and a psychological assessment, finding the applicant failed to prove they were reasonable and necessary due to a lack of contemporaneous supporting medical evidence.

No interest was payable as no benefits were overdue.

The applicant sought various statutory accident benefits, including attendant care, physiotherapy, and occupational therapy, following a 2018 motor vehicle accident.

The adjudicator dismissed the application in its entirety, finding the applicant was a poor historian and failed to meet his onus to prove the expenses were reasonable and necessary or incurred.

The adjudicator preferred the respondent's medical evidence, noting the applicant's significant pre-existing health issues, including severe osteoarthritis that necessitated a knee replacement.

The respondent's request for costs was also denied.

The applicant was injured in a motor vehicle accident and sought income replacement benefits (IRBs) from the respondent insurer.

The adjudicator found that the applicant had returned to work on a full-time basis with unmodified duties prior to the start of her claim for IRBs.

The medical evidence, including the insurer's examinations, did not support a finding that the applicant suffered a substantial inability to perform the essential tasks of her employment.

The application for IRBs and interest was dismissed.

The applicant sought statutory accident benefits following a motor vehicle accident.

The respondent determined the applicant's injuries fell within the Minor Injury Guideline (MIG) and refused to pay for certain medical benefits beyond the $3,500 funding limit.

The applicant argued that pre-existing chronic low back pain precluded her recovery within the MIG.

The Tribunal found that the applicant's injuries were predominantly minor, noting that clinical records and an independent medical examination showed only soft tissue injuries and no evidence that the pre-existing condition would prolong recovery.

Consequently, the disputed treatment plans were deemed not reasonable and necessary, and the claims for benefits and interest were dismissed.